CNM Certified Nurse Midwife

Category - Professional Issues

A 14-year-old comes to the clinic after a home pregnancy test indicated that she is pregnant. Physical examination and laboratory tests confirm that the client is 12 weeks pregnant. The nurse midwife also notes that the client has signs of anorexia nervosa. A series of tests are conducted, revealing anemia. On the second visit, the client informs the nurse midwife that she has decided to have an abortion and she wants to know her options. The nurse midwife tries to encourage the client to talk to her mother, but the client refuses. Which of the following is the next action of the nurse midwife?
  1. Inform the client’s mother about the pregnancy and the client’s plan for abortion.
  2. Thoroughly explain the effects of abortion on the adolescent’s health and how having anorexia nervosa and anemia greatly increase her risk for life-threatening medical conditions after the procedure.
  3. Keep silent about the client’s pregnancy and planned abortion, but be sure to work closely with the client to help her mentally and physically before and after the abortion.
  4. Inform the state about the client’s condition.
Explanation
Answer: B - The next action of the nurse is to thoroughly explain to the effects of abortion and the additional risks posed by anorexia nervosa and anemia. Knowing about the complications involved, the client may agree to inform her mother of the pregnancy. If the client refuses to inform her mother in spite of the teaching, the nurse midwife may report the client’s condition to state officials. When caring for a pregnant adolescent, one of the main goals of a nurse midwife is to encourage the client’s family members to participate in the care. The nurse midwife may implement other activities that may facilitate communication between mother and child before informing the state about the client’s condition.
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